Eurosets TRILLY PAEDIATRIC AF Instrucciones De Uso página 64

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compartment might cause the formation of
gaseous microemboli.
INITIATING BYPASS
1) OPENING THE ARTERIAL AND VENOUS LINES
First remove the clamp from the arterial line
and then the clamp from the venous line. Start
bypass with a blood flow appropriate for the
patient's size.
Constantly check the blood level in the
cardiotomy/venous reservoir.
If performing vacuum-assisted drainage (VAVD),
check that all the ports are closed and apply the
vacuum to the cardiotomy/venous reservoir.
2) CHECKING PROPER FUNCTIONING OF THE
HEAT EXCHANGER
Check the temperature of the venous and arterial
blood.
3) SELECTING THE APPROPRIATE GAS FLOW
The product has characteristics which offer the
possibility of treating a wide range of patients.
The regulation of gas, blood and FiO
normothermia must be performed according to
the table below.
Blood flow ml/min
<1500
1500 – 2500
>2500
After initiating cardiopulmonary bypass, check
the content of gas in the blood with a blood gas
analysis and make any necessary corrections.
WARNINGS
• Always open the gas flow after the blood flow.
The gas blood flow ratio must never exceed
2:1.
• Do not occlude the gas escape port to avoid
that pressure achieved into the gas side
compartment becomes higher than pressure
into the blood site compartment.
• The pressure in the blood compartment
must always be higher than that in the gas
compartment. This is to prevent the formation
of gas emboli in the blood compartment.
• During the heating and cooling phases, pay
attention to the rate of temperature increase
and decrease (gradient).
4) BLOOD GAS ANALYSIS
After a few minutes of bypass, measure the gas
content in the blood. Depending on the values
found, adjust as follows:
flows in
2
FiO % Gas:Blood flow
2
50 1:1
60-70 1:1
70-80 1:1
High pO ==>
2
Low pO ==>
2
High pCO ==>
2
Low pCO ==>
2
DURING BYPASS
1) CHECKING THE VENOUS RETURN
If a higher venous return flow is necessary, lower
both the oxygenator and the cardiotomy/venous
reservoir respect to the patient's position.
With vacuum assisted drainage, the vacuum
applied to the cardiotomy/venous reservoir must
be adjusted in order to obtain adequate venous
return.
WARNINGS
• The ACT (Activated Coagulation Time)
must always be greater than or equal to
480 seconds in order to ensure adequate
anticoagulation of the extracorporeal circuit.
• If administration of anticoagulant to the
patient is necessary use the luer port of the
central stopcock on the sampling manifold.
• The cardiotomy/venous reservoir minimum
operating volume is 100ml at 3.5 l/min, 80ml
at 2 l/min and 30ml/min at 0.5 l/min. To allow
sufficient reaction time in case of sudden
venous flow stop, preventing gaseous emboli
passing to the patient, it is recommended to
maintain the operating level at the double of
the minimum operating volume.
• If performing sampling during vacuum
assisted drainage, please read carefully.
• Perform sampling only when the pump is
running, otherwise the blood pressure in the
compartment would drop and might lead to
the formation of air bubbles.
2) ARTERIAL SAMPLING
Turn all stopcock to allow the blood re-circulation
thanks to the arterial pressure. Insert a sampling
syringe into the arterial stopcock luer and draw
at least 10 ml of blood prior to take the arterial
sample. Return the collected blood in the
central stopcock luer and proceed to the arterial
sampling. Collect the blood sample through
the syringe. Close the arterial stopcock before
removing the syringe. Return the blood residual
from gas analysis in the central stopcock luer.
Ensure to turn all stopcock to allow the blood
re-circulation at the end of the operation.
3) VENOUS SAMPLING
decrease FiO
2
increase FiO2
2
increase gas flow
decrease gas flow